The attachment of the public and the Labour party to the NHS is one of the enduring features of British politics. It’s utterly predictable that the debate over the future shape and organisation of the NHS in Wales is such a controversial topic.
This week, I hosted an event in the Senedd welcoming the Royal College of Paediatrics & Child Health, a member of the Royal College of Obstetricians and Gynaecologists and the national clinical forum, to discuss and debate their views about the choices that we have to make about current and future provision. I’ve met several royal medical colleges and each one says that the need for change is not about money driving change. They have been absolutely consistent – the NHS will see services collapse if change does not happen. Their concerns are driven by safety and quality for staff and the patient.
In principle people accept that the NHS needs to change. The focus should be on organising services to deliver the best treatment possible and that means change. We have too many specialist services spread too thinly in too many places. That does not serve the public well and patient outcomes are too uneven. Or put another way – you are more likely to receive better care depending on where you live. The problem comes when we’re faced with the reality of changing the NHS. The public opposition is not based on demanding better care with improved patient outcomes. The opposition is largely focused on defending the status quo and local-based care.
The matter is also tied up with devolution and its future. The way the NHS works now compared to 20 years ago is radically different. We can’t duck questions about the way the NHS is organised. There are serious question marks over the nature and quality of training being provided for junior doctors. If training can’t take place in some of our hospitals across Wales then the service will be forced to change. We need more staff at more senior grades at a time when there is a recruitment crisis in key specialities including paediatrics, psychology and emergency medicine.
There is a real need for greater openness and honesty in the debate over the future organisation of the NHS. Six local health boards and the Welsh Ambulance Service have joined together to produce a south Wales plan for specialist hospital services. In a few months we will have their recommendations for formal consultation. That will involve change for hospital services in south Wales. That does not mean services will disappear but some people may need to travel further for their treatment.
The choice appears to me to be local care or better care. What parent wants their seriously ill child treated locally if better care is available at a different hospital? The stark choice we face is changing the way we organise and deliver the NHS in a planned way or accept crisis management where services collapse. That is what happened at Neath Port Talbot hospital last year – a crisis change driven by an inability to recruit and train doctors. Do we do something now or do we say that we won’t do what is right because it’s difficult and accept that our service change will be driven by withering services and one unplanned crisis to another? We need political courage to make change happen. After all isn’t this what devolution was supposed to deliver – the ability to make changes in our interests with the responsibility to do just that? It goes to the centre of the first minister’s aim to make this term focused upon delivery. Are we prepared to pay the price to safeguard the future of the NHS or are we prepared to pay the price for doing nothing because it’s difficult?
—————————————————————————————
Vaughan Gething is assembly member for Cardiff South and Penarth. He tweets @VaughanGething
—————————————————————————————